Martha's Case: The Unwelcome Phone Call

Correct! The answer is 4: All of the above.

Martha usually engages in vaginal and oral sex but has also tried anal sex. Therefore she should be tested for gonorrhea at all 3 sites - the cervix, the anus and the throat.

Normally a gram stain and culture are performed for gonorrhea screening and diagnosis. However, nucleic acid amplification tests (NAAT) such as PCR and LCR can be considered as an alternative to culture for diagnosis and screening. At this time NAAT for gonorrhea lacks the high specificity that it has for chlamydia, resulting in more false positives, however the test is continually being improved. Because of the specificity issues, laboratories will follow-up a positive NAAT for gonorrhea with a confirmatory test on the same specimen.

Many mobile units, street programs and rural locales are now using urine NAAT for gonorrhea. To determine whether urine NAAT for gonorrhea is available in your region please contact your local laboratories.